Individual provider Active NPI

Edmond Habash, P.A-C

  • Physician Assistant
  • Great Bend, KS
National Provider Identifier
1194774901
Registry record updated Sep 22, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
1500579 Issued in KS
Practice address
3515 Broadway Ave
Suite 107
Great Bend, KS 67530-3633
Phone
(620) 793-8429
Fax
(620) 793-6014
NPI assigned
May 9, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 22, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 1500579 KS Primary

Addresses

Primary practice location

3515 Broadway Ave
Suite 107
Great Bend, KS 67530-3633

Mailing address

PO Box 310
Great Bend, KS 67530-0310
Phone (620) 786-6475

Other practice location 1

3720 10th St
Great Bend, KS 67530-3543
Phone (620) 796-2135

Other practice location 2

2214 Canterbury Dr Ste 308
Hays, KS 67601-2385
Phone (785) 628-6014

Other identifiers 1

IdentifierTypeStateIssuer
100359440BMedicaidKS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KS
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050420000645 KS Practitioner - Physician Assistant 5496793465 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Hays Medical Center IncGroup PAC ID 1557279676, 188 clinicians

Practice addresses (Care Compare)

2220 Canterbury Dr
Hays, KS 67601-2370
Phone (785) 650-2700

2300 N 14TH Ave
200 Haysmed Multispecialty Clinic in Dodge
Dodge City, KS 67801-2367
Phone (620) 371-5197

3800 10TH St
Great Bend, KS 67530-3549
Phone (620) 796-2135

Hospital & facility affiliations

  • Hays Medical Center Hospital, Hays, KS, CCN 170013
  • Pawnee Valley Community Hospital Hospital, Larned, KS, CCN 171345
  • University of KS HLTH System Great Bend Campus Hospital, Great Bend, KS, CCN 170191
  • Centura St. Catherine-Dodge City Hospital, Dodge City, KS, CCN 170175
  • Hodgeman County Health Center Hospital, Jetmore, KS, CCN 171369

Merit-based Incentive Payment System (MIPS)

Final score
85.72 of 100Reported as apm
Quality
68.82
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Hays Medical Center, Inc CurrentSince Nov 3, 2010 Accepting new patients
Hays Medical Center, Inc. CurrentSince Nov 3, 2010 Accepting new patients
Central Kansas Medical Center Past Accepting new patients
Hays Medical Center, Inc. Past Accepting new patients
Central Kansas Medical Center Past Accepting new patients
Central Kansas Medical Center Past Accepting new patients
Central Kansas Medical Center Past Accepting new patients
Central Kansas Medical Center Past Accepting new patients

Locations

3720 10th St
Great Bend, KS 67530
Phone (620) 792-4006

3800 10th St
Great Bend, KS 67530
Phone (620) 603-4216

2214 Canterbury Dr
Ste 308
Hays, KS 67601
Phone (785) 261-7650

2220 Canterbury Dr
Hays, KS 67601
Phone (785) 623-5000

Interoperability endpoints

  • Direct secure messaging: edmond.habash@haysmeddirect.com

Organizations & group practices 9

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 5

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1147132800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1758499200000",
    "number": "1194774901",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 310",
            "city": "GREAT BEND",
            "state": "KS",
            "postal_code": "675300310",
            "telephone_number": "620-786-6475",
            "fax_number": "620-786-6155"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3515 BROADWAY AVE",
            "address_2": "SUITE 107",
            "city": "GREAT BEND",
            "state": "KS",
            "postal_code": "675303633",
            "telephone_number": "620-793-8429",
            "fax_number": "620-793-6014"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3720 10th St",
            "address_purpose": "LOCATION",
            "city": "Great Bend",
            "state": "KS",
            "postal_code": "675303543",
            "country_code": "US",
            "telephone_number": "620-796-2135",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2214 Canterbury Dr Ste 308",
            "address_purpose": "LOCATION",
            "city": "Hays",
            "state": "KS",
            "postal_code": "676012385",
            "country_code": "US",
            "telephone_number": "785-628-6014",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HABASH",
        "first_name": "EDMOND",
        "credential": "P.A-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-09",
        "last_updated": "2025-09-22",
        "certification_date": "2025-09-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "KS",
            "license": "1500579",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100359440B",
            "state": "KS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Great Bend, KS

Sources for this page

Verify at the official NPI Registry.